Discussion of: “Radioactive seed localization for breast conservation surgery: Low positive margin rate with no learning curve”

2017 ◽  
Vol 214 (6) ◽  
pp. 1094-1095
Author(s):  
Cristine S. Velazco ◽  
Nabil Wasif ◽  
Barbara A. Pockaj ◽  
Richard J. Gray
Keyword(s):  
Learning Curve ◽  
Breast Conservation ◽  
Positive Margin ◽  
Breast Conservation Surgery ◽  
Positive Margin Rate ◽  
Conservation Surgery ◽  
Seed Localization ◽  
Radioactive Seed Localization ◽  
Radioactive Seed

scholarly journals Radioactive Seed Localization for Nonpalpable Breast Lesions in a Community Hospital Setting

2016 ◽  
Vol 5 (1) ◽  
pp. 25
Author(s):  
James A. Wheeler ◽  
Karlyn Harrod ◽  
Fang Liu ◽  
Elizabeth Garber ◽  
Lisa Grove-Narayan ◽  
...  
Keyword(s):  
Hospital Setting ◽  
Positive Margin ◽  
Breast Lesions ◽  
Extensive Literature ◽  
Small Community ◽  
Positive Margin Rate ◽  
Seed Localization ◽  
Radioactive Seed Localization ◽  
Radioactive Seed ◽  
Nonpalpable Breast Lesions

Purpose: To compare the positive margin rates for women with nonpalpable breast tumors whom had wire localization compared to radioactive seed localization in a small community hospital.Introduction: Wire localized (WL) breast biopsies have been performed on patients with nonpalpable breast lesions for many years. Radioactive seed localization (RSL) offers advantages of patient comfort and scheduling convenience.There is an extensive literature from large centers regarding the RSL technique. Little is known whether physicians performing these procedures in smaller community hospitals can achieve comparable negative margin rates as those performed with wire localization.Methods: The thirty-six patients who underwent wire localized breast conserving surgery between September 18, 2013 and December 10, 2014, were compared to the 48 radioactive seed localization patients resected between February 12, 2014 and December 18, 2014. The primary objective was to determine if the introduction of the radioactive seed localization technique significantly changed the positive margin rate.Results: Two of 36 wire localized breast biopsied patients had positive margins, compared to 5 of 48 radioactive seed localization patients, a difference which is not statistically different. The specimen weight was larger for the patients treated with the RSL technique. There was a trend toward a higher positive margin rate with older patients.Conclusion: The positive margin rate was similar between the wire localized and radioactive seed localized patients, and comparable to those in the published literature.

Bracketed Radioactive Seed Localization for Breast Conservation Surgery

2020 ◽  
Vol 86 (2) ◽  
pp. 90-94
Author(s):  
Jordan Dixon ◽  
Bharti Jasra ◽  
Anita Ankola ◽  
Smita Sharma ◽  
Haley Letter
Keyword(s):  
Ductal Carcinoma ◽  
Breast Conservation ◽  
Surgical Margin ◽  
Positive Margin ◽  
Breast Conservation Surgery ◽  
Screening Mammogram ◽  
Average Maximum ◽  
Conservation Surgery ◽  
Seed Localization ◽  
Area Of Concern

We aimed to evaluate the surgical margin outcomes and re-excision rates in patients undergoing bracketed seed localization of biopsy-proven breast cancer detected on screening mammogram. After approval by our Institutional Review Board, we retrospectively identified patients who had undergone iodine-125 seed localized lumpectomy at our institution from January 2010 to June 2017 by one of two fellowship-trained breast surgeons. Of those patients, a subset of 25 patients were identified who had undergone bracketed seed localization, defined as two or more seeds used to delineate the radiographic borders of the area of concern. All patients had originally presented with calcifications identified on screening mammogram that were subsequently diagnosed as ductal carcinoma in situ and/or invasive ductal carcinoma by image-guided biopsy performed at our institution. Eight patients had one positive margin on final surgical pathology and required re-excision (32%). One patient was converted to mastectomy. Of the patients requiring re-excision, the average maximum linear extent of calcifications was 3.4 cm (SD 0.97), whereas it was 3.1 cm (SD 1.2) in patients with negative surgical margins ( P = 0.5). Bracketing calcifications with radioactive seeds can potentially allow more patients to undergo breast conservation surgery.

scholarly journals Initial Community Hospital Performance of Radioactive Seed Localization for Breast Cancer Patients

2017 ◽  
Vol 6 (1) ◽  
pp. 51
Author(s):  
James A Wheeler ◽  
Fang Liu
Keyword(s):  
Community Hospital ◽  
Geometric Mean ◽  
Positive Margin ◽  
Breast Tumors ◽  
Breast Conserving Surgery ◽  
Small Community ◽  
Wire Localization ◽  
Seed Localization ◽  
Radioactive Seed Localization ◽  
Radioactive Seed

Purpose: To compare the positive margin rates for women with nonpalpable breast tumors who underwent breast conserving surgery with wire localization versus those with radioactive seed localization in a small community hospital and to compare the size of the corresponding breast specimens.Introduction: Wire localization (WL) has been the standard technique to assist in the removal of nonpalpable breast tumors for the past three decades for patients undergoing breast conserving surgery. Radioactive seed localization (RSL) is an alternative technique that provides advantages of patient comfort and scheduling convenience. There are numerous studies from large academic centers, but little information on how successfully this technique can be implemented in community hospitals.Methods:         Thirty-five patients who underwent WL between September 18, 2013 and December 10, 2014 were compared to 110 patients who underwent RSL between February 12, 2014 and December 16, 2015. Results: Three of the 35 WL patients (8.5%) had a positive margin compared to 14 of the 110 RSL patients (12.7%), but this difference was not statistically significant (p-value 0.763). The breast specimen weight had a geometric mean of 30.26 g for the WL patients and 32.78 g for the RSL patients, a difference of 8.3%, which was not statistically significant. Positive margin rates did not depend on the surgeon or the radiologist placing the I-125 localization seed.Conclusion: The RSL technique can be implemented in community hospitals with the expectation of having the same positive margin rates as reported from academic centers.

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